Clinical AdvisorPA’s Misdiagnosis Leads to $3 Million Malpractice Verdict

⚖️ Legal/Ethical Complexity

A PA in an understaffed ED diagnosed a 49-year-old with sciatica after a CT scan read as normal. The scan actually showed early signs of a perirectal abscess, missed because the radiologist wasn’t given adequate clinical context.

Legal Takeaways

• Jury awarded $3 million ($1M past, $2M future pain and suffering), finding the PA directly negligent and the hospital vicariously liable.
• Expert testimony confirmed the abscess was visible on the original CT but missed due to insufficient symptom history provided with the imaging order.
• The PA’s defense that symptoms were “atypical” did not overcome jury findings on exam thoroughness and communication failures.
• Radiologist was not named in the suit; liability centered on ordering-clinician documentation and communication, not image interpretation.

Protective Practice

• Avoid premature closure on a common diagnosis before ruling out higher-severity conditions.
• Investigate any symptom that doesn’t cleanly fit the leading diagnosis rather than dismissing it.
• Provide detailed, localized clinical context with every imaging order, not broad or generic requests.
• Document differential diagnoses considered and the specific rationale for ruling each one out.